Organization
SOUTHERN CRESCENT ENDOSCOPY SUITE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUNG WHUN SUH MD (CHIEF MEDICAL OFFICER)
(404) 888-7575
Entity
Organization
Contact information
Practice address
150 N PARK TRL STE A, STOCKBRIDGE, GA 30281-7372
(770) 507-0909
(770) 907-8448
Mailing address
550 PEACHTREE ST NE, SUITE 1600, ATLANTA, GA 30308-2208
(404) 888-7575
(404) 885-7777
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00779402A
—
GA
Enumeration date
06/21/2006
Last updated
06/28/2022
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